A rare complex association of truncus arteriosus with anomalous left coronary artery from the pulmonary artery: A case of rare congenital deformity

Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital deformity, and its association with truncus arteriosus (TA) has been infrequently described in medical literature. We report a case of a 3-year-old child presenting with failure to thrive and recurrent respiratory infections, who was diagnosed with truncus arteriosus type 1 and an anomalous left coronary artery originating from the pulmonary artery. The embryological basis of both TA and ALCAPA involves disruptions in the normal development of the aorticopulmonary septum and coronary arteries. TA results from the failure of the truncal ridges and aorticopulmonary septum to develop and divide properly, leading to a single truncal root that does not separate into the aortic and pulmonic outflow tracts, and a single truncal valve [1]. ALCAPA occurs when the left coronary artery, which should normally arise from the left aortic sinus, anomalously originates from the pulmonary artery [2]. This case underscores the importance of a comprehensive and multidisciplinary approach in diagnosing and treating patients with complex congenital heart disease.